More Rehab Now to Heal Better Later

PT and OT rehab programs that met six days a week produced more independent patients

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

For patients with mobility problems, being consistent with rehab is an important part of the recovery process. It might be helpful for many of these patients to meet more often with their specialist or therapist.

A new study found that physical therapy (PT) and occupational therapy (OT) patients with foot or neurological problems who attended six days of rehab a week were more independent and had an improved quality of life compared to patients who only attended five days of rehab.

The findings showed that doing six days of rehab decreased the overall length of stay in the rehab program by a couple of days. These patients also saw prolonged benefits six months later.

"Discuss all your rehab options with your doctor."

Casey Peiris, a PhD candidate in the Department of Physiotherapy at La Trobe University in Australia, led this study investigating whether more frequent and longer rehabilitation visits helped older patients recover faster.

The researchers looked specifically at two kinds of therapy: physiotherapy (more commonly known as physical therapy) and occupational therapy. Physical therapy focuses on helping patients regain mobility while occupational therapy helps patients return to normal daily activities. 

This study included almost 1,000 patients who sought treatment at one of two publicly funded Australian rehabilitation facilities for a foot or neurological condition. The patients averaged about 74 years of age and received either occupational or physical therapy. 

The patients were randomly assigned to one of two treatment durations. Half the participants received rehab services five days a week from Monday through Friday. The rest went to rehab six days a week from Monday to Saturday.

Adding a rehab session on a Saturday increased rehab time by 53 minutes on average, or 13 percent overall. 

The researchers found that the patients who had six days of rehab each week functioned more independently overall and had a better quality of life at the time they were discharged compared to those who participated in the five-day rehab program.

Furthermore, the patients who had six days of rehab per week were 17 percent more likely to see more significant improvements six months later compared to the patients who spent less time in rehab each week.

The overall length of stay was two days shorter for patients who did the longer weekly rehab sessions compared to those who had the shorter weekly rehab sessions.

According to the researchers, patients who had a greater number of rehab sessions each week might have been more motivated to achieve their rehab goals because they saw their physical therapists and occupational therapists more often.

"Most improvement occurred during inpatient rehabilitation when therapy was being provided with only relatively small gains following discharge," the researchers wrote in their report.

The increased motivation to improve among patients who spent more time each week in rehab also may have translated to increased activity on their own.

The investigators noted that they could not determine whether patients with certain diagnoses would have benefited the same way with six days of rehab each week over five days.

In addition, the researchers did not look at how duration of treatment affected other rehab programs, such as those involving podiatrists, dietitians and social workers.

The researchers said that future research should look at how rehab over the course of a whole week affects patients in their recovery.

"This is a very well done study that adds to the clinical evidence that increasing the frequency or intensity of physical therapy leads to better outcomes and recovery," Kourosh Parsapour, MD, CEO of 5plus, told dailyRx News.

"Also, the rapid growth of the elderly population and those with chronic disease has exponentially exceeded the amount of physical and occupational therapists available to provide care; therefore, less time has become available per patient to provide effective PT/OT. Lastly, therapists have to use outdated measurement tools for patient assessments which can be very manual and time-consuming, and there are newly mandated regulations that require additional and more detailed limitation coding and reporting," Dr. Parsapour explained.

"So essentially, therapists in the United States are being asked to do a lot more with a lot less time, and all the while getting paid less.  Fortunately, 5plus and a handful of other groups are developing digital health tools to address these inefficiencies and thus provide an environment where the findings of this study can be implemented for impact," said Dr. Parsapour. 

This study, funded by a grant from Eastern Health and La Trobe University from the National Health and Medical Research Council (NHMRC) Australia, was published online September 10 in the journal BMC Medicine. The authors reported no conflicts of interest.

Review Date: 
September 13, 2013
Last Updated:
September 18, 2013